[Acute urine retention: Epidemiology, optimization of the care pathway and alternative to permanent bladder drainage]

Abstract

Introduction: The aim of this narrative review was to report the most relevant data on the contemporary management of Acute Urine Retention (AUR).

Methods: A narrative synthesis of the articles in French and English available on the Pubmed database was carried out in June 2021. We explored the registry of Surveillance sanitaire des urgences et des décès (SurSaUD®, Santé Publique France) to rise original data regarding the epidemiology of AUR in France.

Results: AUR is a therapeutic emergency that requires a rapid bladder drainage. The average age is 71 years, 87 % are men and the stay in the emergency department is >4hours. In France, the hospitalization rate for UAR is steadily decreasing from 42% in 2014 to 32% in 2019. The introduction of an α-blocker increases the chances to get rid of the urinary catheter of 47% to 77% versus placebo. A post-emergency AUR pathway allows lowering the number of people lost with follow-up and shortening the duration of bladder drainage. The first try for catheter removal should be organized within 48-72hours of the AUR. In case of unsuccessful catheter removal, it is recommended to teach self-catheterization to the patient. The placement of a temporary prostatic stent is a promising alternative that is under evaluation. Immediate surgery is associated with increased morbidity/mortality and is not recommended.

Conclusion: AUR is a common disease. The management has been optimized in recent years to improve the prognosis and the quality of life of patients.

Keywords: Acute urinary retention; Auto-sondage propre intermittent; Chirurgie; Clean intermittent self-catheterization; Rétention aiguë d’urines; Sonde urinaire; Surgery; Urinary catheter; α-blocker; α-bloquant.